title: The recovery of fertility during breast-feeding in Assiut, Egypt.
abstract: A longitudinal study of twenty-six breast-feeding and twelve non-breast-feeding postpartum women was conducted in Assiut, Egypt in order to determine the time that ovulation resumed after childbirth, and the effect of breast-feeding frequency on the period of lactational anovulation. Breast-feeding women experienced the onset of follicular development, vaginal bleeding, ovulation and pregnancy significantly later than women who did not breast-feed. Ovulatory and non-ovulatory breast-feeders reported similar frequencies of breast-feeding episodes. The introduction of dietary supplements commonly preceded ovulation. An algorithm using three simple variables observable to the breast-feeding mother was found to predict up to 100% of the first ovulations. All breast-feeding women who did not give supplements and did not have a vaginal bleeding episode by 6 months postpartum were anovular by strict criteria for ovulation. Ovulation did not precede bleeding or supplementation in the women who experienced these events before 6 months, yielding a highly effective formula for preventing unplanned pregnancy by the informed use of breast-feeding.
authors.affiliation: Department of Obstetrics and Gynaecology, Assiut University, Egypt.
authors.forename: M M
authors.initials: MM
authors.lastname: Shaaban
authors.forename: K I
authors.initials: KI
authors.lastname: Kennedy
authors.forename: G H
authors.initials: GH
authors.lastname: Sayed
authors.forename: S A
authors.initials: SA
authors.lastname: Ghaneimah
authors.forename: A M
authors.initials: AM
authors.lastname: Abdel-Aleem
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding; D004534:Egypt; D005260:Female; D005298:Fertility / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D010060:Ovulation